Article Text

ASSESSMENT OF CARDIAC FUNCTION AND ESTIMATION OF BLOOD VOLUMES BY TRANSPULMONARY THERMODILUTION IN AN EXPERIMENTAL PEDIATRIC MODEL
  1. P Cruces1,2,
  2. F Diaz3,
  3. A Donoso2,
  4. C Carvajal3,
  5. T Salomon1,
  6. B Erranz1
  1. 1Instituto de Ciencias, Facultad de Medicina Clinica Alemana, Universidad Del Desarrollo, Santiago de Chile, Chile
  2. 2Area de Cuidados Criticos, Hospital Padre Hurtado, Santiago de Chile, Chile
  3. 3Facultad de Medicina Clinica Alemana, Universidad Del Desarrollo, Santiago de Chile, Chile

Abstract

Background Hemodynamic monitoring and estimation of blood volumes by transpulmonary thermodilution (TPTD) has been widely validated in adults. However, clinical and experimental data is scant in pediatrics, even more in patients weighed less than 10 kg.

Objective to determine baseline values of cardiac function and blood volumes measured by TPTD in a pediatric animal model.

Method Open experimental descriptive animal study approved by our institution’s ethics committee. 42 pigs, weighed 4,9±0,34 kg anesthetized and mechanically ventilated were instrumented with a venous central catheter and PiCCO® catheter (Pulsion Medical, Munich, Germany). After 30 minutes of hemodynamic stabilization the cardiac output was measured by TPTD with PiCCO system. Cardiac Index (CI) (L/min/m2), Systolic Volume Index (SVI) (mL/m2), Cardiac Function Index (CFI) (1/min), Extravascular Lung Water Index (ELWI) (mL/kg), Global End-Dyastolic Volume Index (GEDI) (mL/m2), Intrathoracic Blood Volume Index (ITBI) (mL/m2), Pulmonary Vascular Permeability Index (PVPI), Pulse Pressure Variation (PPV)(%) and Systolic Volume Variation (SVV)(%) were registered. These results were compared with known published data.

Results Are shown in table and expressed as average and SD.

Conclusion

Cruces et al

CI and contractility variables were similar to published references. The preload baseline measurements were lower than adult data, but ELWI was higher. It is important to be aware that the decision tree was proven in adults and it may have different endpoints in pediatric setting.

Funding source: Sociedad Chilena de pediatría.

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